Clinical Profiles of Cardiovascular Diseases and Predictors of Outcome of Hospitalization in a Tertiary Teaching Hospital, Ethiopia: A Prospective Observational Study

Abstract

Background: Documentation of cardiovascular diseases (CVDs) including major contributors to hospitalization and their outcomes in sub-Saharan Africa and Ethiopia is important to prioritize further research, prevention and treatment strategies. Objective: This study aimed to describe the clinical profiles of CVD admissions, risk factors, and patient outcomes at Ayder Comprehensive Specialized Hospital (ACSH) in Tigray, Ethiopia. Methods: Data of patients with the diagnosis of CVD was collected prospectively from Nov. 1, 2017 – Oct. 31, 2018 for patients admitted to medical wards and ICU of ACSH. Socio-demographic profiles, final admission diagnosis, duration of hospital stay and outcomes of hospitalization were variables recorded using a data abstraction checklist. Diseases were categorized using the World Health Organization’s International Classification of Diseases (ICD)-10 coding system. Data was analyzed using SPSS version 26. Results: Of the 2084 admissions over 1 year period, 767 (36.5%) had CVDs. The mean age of the study population was 53.4 ± 19.4 years with 55% females. Leading CVD admissions were stroke (35%), Venous thromboembolism (17%), rheumatic heart disease (RHD) (16.2%), ischemic heart disease (IHD) (11.3%) and cardiomyopathy (CMP) (7.4%). Heart Failure (HF) was found in 300 (39.1%) patients with structural heart disease. The structural cardiac lesions in those with HF were RHD (36%), CMP (19%), IHD (18%) and Cor pulmonale (9%). The in-hospital mortality of all CVD admissions was 13.2%. Of the total 101 CVD deaths most were because of stroke (n=37, 36.6%) followed by IHD (18.8%). Hypertension was the most frequent risk factor (28.8%). Conclusion: This study shows stroke to be the most common form of CVD and RHD to be the main reason for HF among hospital admissions in Northern Ethiopia, ACSH. Hypertension is the leading reported risk factor and hence the need to give high priority to hypertension and RHD control programs.